We know how to change the dietary habits of motivated individuals. The
results of our past randomized intervention trials indicate that if people
are ready and motivated to change dietary behaviors, the likelihood of
success is very high. We know far less about how to change the dietary
habits of individuals who are not yet motivated to attempt changes. We
hypothesize that two finding from our own and others' research will
increase motivation for dietary change: the relationship of social support
to health behaviors, and the effects of messages specifically designed to
motivate individuals to change. This proposal will rigorously test an
intervention package, based on our previous experience, designed to change
dietary practices (lowering fat, increasing fruit and vegetable
consumption) among lower socioeconomic (SES) families in religious
organizations. We selected religious organizations because of the
important role they play in the lives of their members and because of the
social and supportive messages that can be delivered by them. The
intervention package will deliver social support and motivating messages,
as well as materials and skill-building opportunities for dietary change.
Forty religious organizations will be randomized to intervention or
comparison status. The 18-month intervention package, based on a merger of
Social Learning Theory and Trans-theoretical Model of Behavior Change,
will consist of material adapted from interventions of proven efficacy
that present strategies for changing current behavior, messages that
influence motivations and beliefs, and organization-wide interventions
that affect environmental variables. We will base evaluation upon a
randomly selected cohort from each religious organization's mailing list.
Dietary habits will be assessed at baseline and 6 and 18 months follow-up,
using a modified version of the Fat and Fiber Behavior Questionnaire, with
a subset selected to receive 24-hour recalls. The intervention process
will be measured and used as a mediator of dietary change in all
intervention organizations. The primary outcome will be the difference in
change in fat scores between intervention and comparison religious
organizations.